Cord Blood Bank Accounts Suddenly Look A Lot Smarter

Yesterday's on-line publication in the journal Nature Biotechnology of the paper "Isolation of amniotic stem cell lines with potential for therapy" has created a media firestorm with the announcement that stem cells have been identified in the human placenta. The multipotent amniotic fluid-derived stem cells (AFS cells) are described as nearly as powerful as pluripotent embryonic stem cells, but they can be harvested from ubilical cord blood either in or ex utero -- no embryos are destroyed in the process. AFS cells are easy to grow in the lab, and unlike embryonic cells, they don't develop the benign tumors called teratoma.

In the seven year study, scientists at the Wake Forest Institute for Regenerative Medicine and Harvard Medical School led by Dr. Anthony Atala were able to grow AFS cells into muscle, bone, fat, blood vessel, nerve and liver cells. Since the late 1980s, doctors have transplanted the hematopoietic stem cells found in umbiical cord blood to treat blood diseases. Now the AFS cells promise a wider range of therapies in the future.

The early buzz in the general press focuses on the non-destructive harvesting of AFS cells. The contentious ethical issues surrounding destroying embryos for research have been rendered moot, it would seem. But another aspect of the new findings shows how science develops faster than the policies we make to manage it.

PUBLIC VS PRIVATE CORD BLOOD

There are two kinds of cord blood banks that capture and store umbilical cord and placenta blood for transplant. Public cord blood banks receive altruistic donations of material that is made available to anyone who needs it, just like whole blood and bone marrow banks. Private cord blood banks charge new moms and dads several thousands of dollars to collect and store their child's placental blood for their family's future private use. In the last ten years, the  American Academy of Pediatrics, American College of Obstetricians and Gynecologists, and the United Kingdom's Royal College of Obstetricians and Gynaecologists has discouraged private banking, and authorities in France and Italy ban it outright.

The debate is well presented in last year's PLoS Medicine article "Can Routine Commercial Cord Blood Banking Be Scientifically and Ethically Justified?" The case against private umbilical cord blood (UCB) collection comes down to five points:

1. Public donations are adequate to treat most blood diseases in which rejection of the transplanted  cells is not a problem.
2. Collecting and storing private material is logistically difficult.
3. The hard-sell of commercial cord blood services to new parents at a vulnerable time is coercive.
4. We can't be sure private companies will maintain high standards or even stay in business long enough to deliver needed transplant blood.
5. "Other uses for UCB remain speculative since it is unclear whether non-haemopoietic stem cells are present in sufficient numbers for use against degenerative conditions."

Now, "other uses" are a lot less speculative: other kinds of stem cells are in UCB. Concerned parents only get once chance to collect umbilical cord blood, and even at $2,000 per child, it seems like a cheap spare parts kit if the new AFS cells turn out to be useful in medical therapies in 20 or 50 or 100 years when the kid or some other family member needs it.  To heck wih a college account, put away some stem cells for a rainy day.

Comments

[Cord Blood]

Excellent article !
"But another aspect of the new findings shows how science develops faster than the policies we make to manage it.." sometimes it's on purpose .

[Dr Norman Blumenthal]

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